Clinical Specialist jobs in United States

Explore 274 matching jobs.

INTEGRIS Health

RN Clinical Reimbursement Specialist

INTEGRIS Health

Posted: 10/22/2026
Medtronic

Clinical Specialist, Deep Brain Stimulation

Medtronic

Posted: 10/21/2026
Haemonetics

Senior Clinical Specialist, Interventional Technologies

Haemonetics

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GE HealthCare

Clinical Application Specialist, Point-of-Care Ultrasound

GE HealthCare

Posted: 10/21/2026
Medtronic

Clinical Specialist, Deep Brain Stimulation

Medtronic

Posted: 10/21/2026
Coloplast

Clinical Specialist

Coloplast

Posted: 10/21/2026
Baxter International Inc.

Clinical Education Specialist

Baxter International Inc.

Posted: 10/21/2026
Aledade, Inc.

Clinical Outreach Specialist

Aledade, Inc.

Posted: 10/21/2026
Healthfirst

Appeals and Grievances Clinical Specialist

Healthfirst

Posted: 10/21/2026
Stryker

Clinical Specialist, Joint Replacement

Stryker

Posted: 10/21/2026
Abbott

Clinical Specialist, Coronary

Abbott

Posted: 10/20/2026
GE HealthCare

Clinical Applications Specialist – Invasive Cardiology

GE HealthCare

Posted: 10/20/2026
GE HealthCare

Clinical Applications Specialist, Invasive Cardiology

GE HealthCare

Posted: 10/20/2026
GE HealthCare

Clinical Applications Specialist, Invasive Cardiology

GE HealthCare

Posted: 10/20/2026
GE HealthCare

Clinical Applications Specialist, Invasive Cardiology

GE HealthCare

Posted: 10/20/2026
Ipsen

Senior Clinical Science Specialist, Rare Disease / Liver

Ipsen

Posted: 10/20/2026
Abbott

Clinical Specialist, Coronary

Abbott

Posted: 10/20/2026
Hamilton Medical

Regional Clinical Applications Specialist

Hamilton Medical

Posted: 10/20/2026
Avispa

Clinical Informatics Specialist

Avispa

Posted: 10/20/2026
MS SQL ServerOracleSQL
Avalon Healthcare Solutions

Clinical Policy, Government Programs Specialist

Avalon Healthcare Solutions

Posted: 10/20/2026
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INTEGRIS Health

RN Clinical Reimbursement Specialist

INTEGRIS Health
Posted 10/22/2026full-timeOklahoma City • Oklahoma • United StatesSeniorLeadWebsite
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Core Competencies

Role fit
Core Competencies

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Demonstrates expertise in clinical appeals management, denial analysis, and reimbursement strategies within healthcare settings. Proficient in navigating government and managed care regulations while providing training and support to recovery staff.

Highest-signal resume keywords
Licensed Practical Nurse (LPN) or Registered Nurse (RN)Clinical Appeals ManagementDenial Management ProcessManaged Care ExperienceHealthcare Financial Analysis

About the role

Key responsibilities & impact
  • Identify and prepare clinical appeals for government, managed care organizations, and other payors
  • Provide assistance and guidance in maintaining the charge description master for the INTEGRIS Health system
  • Assist the Director of Revenue Recovery with training and development of recovery staff on clinical and non-clinical payment issues
  • Oversee and manage the INTEGRIS System clinical denial management process
  • Identify denial and payment trends and help develop plans to maximize reimbursement
  • Participate in the Utilization Management Committee to report denial issues and develop preventive strategies with physicians
  • Analyze, prepare, and distribute monthly denial reports to hospital leadership
  • Respond to utilization management clinical denials for Medicare and Medicaid programs
  • Support Case Management and hospital departments with clinical expertise regarding payor and patient clinical denial inquiries
  • Assist with chargemaster development, implementation, maintenance, and audits
  • Analyze denial trends and facilitate cross-departmental collaboration to improve processes and develop best practices
  • Identify charging, coding, or clinical documentation issues and work with ancillary departments to resolve them
  • Maintain practical knowledge of government and managed care payer rules, regulations, and requirements
  • Report to the assigned Corporate Manager

Requirements

What you’ll need
  • Current licensure as a Licensed Practical Nurse (LPN) or Registered Nurse (RN) in the State of Oklahoma, or current multistate license from a Nurse Licensure Compact (eNLC) member state
  • 8 years' experience working with healthcare facilities, health insurance or managed care companies, and 10 years demonstrated experience working with healthcare facilities, health insurance or managed care companies
  • 6 years of direct managed care or case management experience
  • Knowledge and proficiencies with government rules and regulations, managed care contracts, provider relations, pre-certification, reimbursement, financial analysis, and patient accounting
  • Knowledge of legal documents, collection agency procedures, and contract documents
  • Must be able to communicate effectively in English (Verbal/Written)

Benefits

Comp & perks
  • Front-loaded PTO
  • Medical benefits through the extensive INTEGRIS Health network
  • Financial assistance for continued education
  • 24/7 mental health support
  • Career and development opportunities

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills
Clinical Denial AnalysisCharge Description Master MaintenanceUtilization ManagementReimbursement StrategiesCoding and Documentation ReviewFinancial AnalysisPatient AccountingManaged Care ContractsPre-Certification ProcessesLegal Document Knowledge
Soft Skills
Effective CommunicationCross-Departmental CollaborationTraining and Development
Certifications & Qualifications
Licensed Practical Nurse (LPN)Registered Nurse (RN)
Industry Keywords
Healthcare FacilitiesManaged Care OrganizationsGovernment RegulationsDenial TrendsPayment IssuesCase ManagementProvider RelationsCollection Agency Procedures